Questions and Answers
Which test should be performed for a patient with suspected stroke as early as possible?
What are the signs indicating cardiac arrest in an unresponsive patient?
Agonal gasps
What should be the recommended next step after a defibrillation attempt?
Resume CPR, starting with chest compressions
During post-cardiac arrest care, what is the recommended duration of targeted temperature management after reaching the correct temperature range?
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What is the next step in assessment and management of a patient who is unresponsive?
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What should you administer first despite 2 defibrillator attempts failing?
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What immediate action should be taken when a patient has a return of spontaneous circulation but cannot follow commands?
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What should be the primary focus of a CPR coach?
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Which is the primary purpose of a medical emergency team or rapid response team?
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What is the recommended aspirin dose?
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How can you increase chest compression fraction during a code?
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What is the max interval to allow for interruption in chest compressions?
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What is the recommended maximum goal time for medical contact-to-contact balloon inflation for STEMI patients?
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What compression rate is recommended?
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What condition do you suspect led to the cardiac arrest based on the initial presentation?
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Study Notes
Non-contrast CT
- Essential for early detection of suspected stroke.
- Should be performed as quickly as possible following the onset of symptoms.
Monomorphic Ventricular Tachycardia
- A specific type of arrhythmia that can be identified during ECG monitoring.
Oropharyngeal Airway Measurement
- Measured from the corner of the mouth to the angle of the mandible to ensure proper sizing.
Fibrinolytic Therapy and Endovascular Therapy
- Administer fibrinolytic therapy as soon as possible for patients with suspected stroke within a suitable time frame.
CPR Post-Defibrillation
- Resume CPR immediately after a defibrillation attempt, focusing on chest compressions to maintain blood flow.
Agonal Gasps
- May indicate cardiac arrest in an unresponsive patient; requires immediate assessment.
12-lead ECG Evaluation
- A critical assessment tool for patients presenting with chest discomfort and unstable vital signs.
Targeted Temperature Management Duration
- Recommended for at least 24 hours post-cardiac arrest after achieving the desired temperature.
Second-degree AV Block Type 1
- A condition that may cause variable heart rhythms; assessment and management are crucial.
Patient Breathing and Pulse Check
- Immediate assessment step for unresponsive patients to determine the need for CPR.
Ventricular Fibrillation in Acute Coronary Syndrome
- Associated with symptoms like chest discomfort in patients with coronary stents.
Cardiac Arrest Suspicions
- Chest compressions are often indicative of conditions leading to cardiac arrest.
Epinephrine Administration
- Administer 1 mg IV of epinephrine for a patient in ventricular fibrillation after unsuccessful defibrillation attempts.
Lidocaine for V.fib
- Use 1-1.5 mg IV for patients experiencing ventricular fibrillation that does not respond to initial treatments.
Immediate Care Post-Cardiac Arrest
- Initiate targeted temperature management if the patient shows return of spontaneous circulation but is unresponsive.
Synchronized Cardioversion
- Recommended for patients with unstable rhythms that present with a pulse, but not in ventricular fibrillation.
Increasing Chest Compression Fraction
- Charge the defibrillator before conducting rhythm checks to reduce interruptions in CPR.
Team Role Management
- Encourage team members to request new task roles if found to be beyond their capabilities.
Continuous Waveform Capnography
- Essential for the confirmation and monitoring of endotracheal tube placement post-intubation.
Monitoring PetCO2
- Increases the quality of CPR by assessing effectiveness and guiding ventilation.
Ineffective Compressions Indicator
- A PetCO2 level reading of 8 signifies poor or ineffective compressions.
Third-degree AV Block
- Serious heart condition requiring prompt intervention and assessment.
Immediate Team Correction
- Address team member errors right away to avert potential mistakes in resuscitation scenarios.
Adenosine Dosage Strategy
- Administer 12 mg of adenosine following initial doses for stable narrow complex tachycardia.
Second-degree Type II Block
- A specific type of heart block that requires appropriate clinical attention.
Medical Emergency Teams (MET)
- Focused on improving patient outcomes through the early identification and treatment of clinical deterioration.
Amiodarone Administration
- Standard order is 300 mg as the first dose for ventricular fibrillation.
Recommended Aspirin Dose
- Dosage of 162-325 mg for patients with suspected acute coronary syndrome.
Epinephrine in Cardiac Arrest
- Administer 1 mg IV of epinephrine after 2 minutes of CPR and confirming pulselessness.
Minimum Systolic Blood Pressure
- Target a systolic BP of at least 90 mmHg for optimal perfusion.
CPR Coaching Focus
- Primary aim should be ensuring high-quality CPR is maintained throughout resuscitation efforts.
Monomorphic V Tach Algorithm
- The ACLS algorithm for adult tachycardia with a pulse specifically addresses monomorphic V tach cases.
Oxygen Application
- Initial response to low oxygen saturation levels (84% on room air) involves applying supplemental oxygen.
Synchronized Cardioversion Intervention
- Used for patients presenting with an unstable pulse and abnormal heart rhythms.
Defibrillation Approach
- Indicated for patients who are apneic and pulseless.
Team Leadership in Resuscitation
- Effective delegation of tasks is crucial to minimize inefficiencies during a resuscitation attempt.
Excessive Ventilation Consequence
- Can lead to decreased cardiac output and compromise patient care.
Pulse Check Duration
- Ensure pulse checks during BLS assessment last no longer than 5-10 seconds.
Amiodarone Dosing for Refractory V.fib
- First dose for refractory ventricular fibrillation is recommended at 300 mg.
Appropriate EMS Destination Post-Cardiac Arrest
- Transport patients to coronary reperfusion-capable medical centers after return of spontaneous circulation.
Defibrillation Logic
- Indicated for patients in ventricular fibrillation according to ACLS protocols.
Timely Interventions for STEMI Patients
- Aim for a maximum goal time of 90 minutes from medical contact to balloon inflation in suspected STEMI cases.
Compression Rate
- Maintain a chest compression rate of 100-120 compressions per minute during CPR.
Chest Compression Interruption
- Limit interruptions to a maximum of 10 seconds to maintain circulation.
Proper Ventilation Timing
- Ensure ventilation is provided once every 6 seconds during resuscitation efforts.
Prehospital Stroke Notification
- EMS should provide timely prehospital notification for patients with suspected strokes to optimize care.
Synchronized Cardioversion for Monomorphic V Tach
- Utilized for patients with a pulse in a state of unstable monomorphic ventricular tachycardia.
Targeted Temperature Management Range
- Recommended range is 32-36 degrees Celsius for 24 hours post-cardiac arrest.
Unstable Supraventricular Tachycardia
- A condition requiring rapid assessment and timely intervention during ACLS protocols.
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